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1.
Article in English | WPRIM | ID: wpr-914875

ABSTRACT

Background@#and Purpose This study aimed to identify the epidemiological features of Guillain-Barré syndrome (GBS) in the Korean population. @*Methods@#Patients with GBS were defined as those who were hospitalized with a primary diagnostic code of G61.0 on the Korean Classification of Disease in a department of neurology, rehabilitation medicine, or pediatrics. We evaluated the incidence and prevalence of GBS as well as physical disability, mortality, and cause of death in patients with GBS from 2002 to 2018 in the Korean population using the Korean National Health Insurance Service database. @*Results@#We identified 11,146 patients with GBS. The ratio of males to females was 1.48. The age-adjusted incidence rate per 100,000 persons increased steadily from 0.84 in 2002 to 1.68 in 2018, as did the age-adjusted prevalence rate per 100,000 persons, from 0.77 to 15.62. The incidence and prevalence of GBS increased with age, peaking at 70–79 years. Among 10,114 patients without physical disability at the time of GBS being diagnosed, 502 (5.0%) patients had moderate disability and 526 (5.2%) had severe disability by the end of the study period.A total of 1,221 (11.0%) patients with GBS died during the mean follow-up period of 17 years (2002–2019). There were 144 (1.3%) in-hospital deaths. @*Conclusions@#This was the first nationwide epidemiological study of patients with GBS covering the entire population including patients of all ages in the Republic of Korea. We have revealed the seasonality of admissions, disability, and long-term mortality rates in patients with GBS.

2.
Kosin Medical Journal ; : 51-55, 2021.
Article in English | WPRIM | ID: wpr-902621

ABSTRACT

Contrast-induced encephalopathy (CIE) following cerebral angiography has similar clinical presentations to ischemic complications of cerebral angiography. Neurologic deficits in CIE are mostly transient, but those caused by acute cerebral infarction (ACI) as ischemic complications of cerebral angiography may be permanent. Therefore, distinguishing CIE from ACI is important. Diffusion restriction on magnetic resonance imaging (MRI) implies ACI, while hyperintensity on diffusion weighted imaging (DWI) without correlation on the apparent diffusion coefficient (ADC) map implies CIE. We reported a rare case of CIE with diffusion restriction on MRI following cerebral angiography that mimicked MRI findings of ACI. The mechanism of this phenomenon remains unknown and requires further investigation.

3.
Article in English | WPRIM | ID: wpr-901912

ABSTRACT

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

4.
Article in English | WPRIM | ID: wpr-901392

ABSTRACT

Shock thyroid is a rare manifestation of the CT hypotension complex and can be diagnosed when thyroid and perithyroidal edemas are observed on CT during the onset of shock. Shock thyroid can be a useful CT sign for decompensated shock. This condition is reversible and recovers rapidly with adequate treatment. We present the case of an 84-year-old female with septic shock, exhibiting CT features consistent with a shock thyroid. We also reviewed the clinical and radiological findings reported in the literature. The present case emphasizes that shock thyroid can be an early indicator of impending hemodynamic instability and has important prognostic and therapeutic implications.

5.
Article in Korean | WPRIM | ID: wpr-900935

ABSTRACT

Background@#Pompe disease is a rare autosomal recessive disorder caused by the deficiency of a lysosomal enzyme, acid alpha-glucosidase (GAA). Early diagnosis and initiation of treatment with enzyme replacement therapy have remarkable effects on the prognosis of Pompe disease. We performed the expanded screening for late onset Pompe disease (LOPD) at eight centers in Korea. @*Methods@#From September 1, 2015, GAA activity were measured from both dried blood spot (DBS) and mixed leukocyte for 188 available patients. For 12 patients with low GAA activity, we performed Sanger sequencing of GAA gene. @*Results@#Among 188 patients, 115 were males. The mean of age of symptom onset and diagnosis were 34.3 years and 41.6 years. Among 12 patients with decreased GAA activity, two patients were confirmed to have LOPD with genetic test (c.1316T>A [p.M439K] + c.2015G>A [p.R672Q], c.1857C>G [p.S619R] + c.546G>C [leaky splicing]). Other two patients had homozygous G576S and E689K mutation, known as pseudodeficiency allele. @*Conclusions@#This study is expanded study of LOPD screening for targeted Korean population. We found two patients with LOPD, and the detection rate of LOPD is 1.06%. With application of modified GAA cutoff value (0.4), which was previously reported, there were no false positive results of GAA activity test using DBS. Therefore, it could be an appropriate screening test for LOPD in especially East-Asian population, in which pseudodeficiency allele is frequent.

6.
Article in English | WPRIM | ID: wpr-900141

ABSTRACT

Objective@#: The widely accepted treatment option of a traumatic carotid cavernous fistula (TCCF) has been detachable balloon or coils based fistula occlusion. Recently, covered stent implantation has been proving an excellent results. The purpose of this study is to investigate our experiences with first line choice of covered stent implantation for TCCF at level 1 regional trauma center. @*Methods@#: From November 2004 to February 2020, 19 covered stents were used for treatment of 19 TCCF patients. Among them, 15 cases were first line treatment using covered stents. Clinical and angiographic data were retrospectively reviewed. @*Results@#: Procedures were technically successful in all 15 cases (100%). Immediate angiographic results after procedure were total occlusion in 12 patients (80%). All patients except two expired patients had image follow-up (mean 15 months). Recurred symptomatic three patients underwent additional treatments and achieved complete occlusion. Mean clinical follow-up duration was 32 months and results were modified Rankin Scale 1–2 in five, 3–4 in five, and 5 in three patients. @*Conclusion@#: The covered stent could be considered as fist line treatment option for treating TCCF patients especially in unstable vital sign. Larger samples and expanded follow-up are required to further develop their specifications and indications.

7.
Article in English | WPRIM | ID: wpr-899611

ABSTRACT

Purpose@#Currently, the most recommended method for burn first aid is the cool running water for 20 minutes (CRW20). If CRW20 is not practicable, cooling dressing products with tea tree oil are used as substitutes. In this study, we analyze the effect of various burn first aids, including CRW20, cooling products, on the treatment period. @*Methods@#This study was conducted on patients who suffered burns and visited Hangangsoo Hospital from March 2019 to March 2020. The study conducted in a retrospective method. The duration of treatment was analyzed by dividing the experimental group. @*Results@#The treatment period was shortened when first aid was given (P<0.001). Cold water, ice, and ice packs resulted in reduced treatment periods (P<0.001, P=0.004). The treatment period was reduced when cooling dressing products were used in all groups (P=0.041). The implementation of first aid has reduced the duration of burn treatment. This means that cooling helps burn treatment. CRW20 did not show statistically meaningful results. This is the result of a failure to fully control the temperature and time of tap water. In addition, the change in temperature of tap water according to season, the use of water is higher than that of animal testing, and the general lack of information on proper burn first aid may have affected. @*Conclusion@#The treatment period was statistically significantly reduced in the group that performed first aid. Among the various first aid methods, cold water and ice reduced the treatment period.

8.
Article in English | WPRIM | ID: wpr-896936

ABSTRACT

Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

9.
Kosin Medical Journal ; : 51-55, 2021.
Article in English | WPRIM | ID: wpr-894917

ABSTRACT

Contrast-induced encephalopathy (CIE) following cerebral angiography has similar clinical presentations to ischemic complications of cerebral angiography. Neurologic deficits in CIE are mostly transient, but those caused by acute cerebral infarction (ACI) as ischemic complications of cerebral angiography may be permanent. Therefore, distinguishing CIE from ACI is important. Diffusion restriction on magnetic resonance imaging (MRI) implies ACI, while hyperintensity on diffusion weighted imaging (DWI) without correlation on the apparent diffusion coefficient (ADC) map implies CIE. We reported a rare case of CIE with diffusion restriction on MRI following cerebral angiography that mimicked MRI findings of ACI. The mechanism of this phenomenon remains unknown and requires further investigation.

10.
Article in English | WPRIM | ID: wpr-894208

ABSTRACT

This study was performed to evaluate the effects of microstructural change of zirconia surface on tensile bond strength with resin cement. The zirconia partially sintered block was cut into a size of 18 × 18 × 7 mm, and then the Zirface slurry (DMAX, Daegu, Korea) containing 15% and 30% zirconia was applied and followed by sintering at 1530 ℃ for 2 hours. Resin cement (PermaCem 2.0, DMG, Hamburg, Germany) was applied on zirconia specimen and polymerized to prepare an 18 × 18 × 14 mm block. In addition, for comparison of bond strength, specimens were prepared for the group that was polished and the group that was blasted at 3 atm using 110 µm alumina. Thereafter, all blocks were cut into a cross-sectional area of 1.0 × 1.0 mm to prepare 12 specimens. The specimens were immersed in distilled water at 37 ℃. for 10 days for aging treatment. A holder for tensile testing was attached to each of the specimens, and then a tensile force was applied at a crosshead speed of 0.5 mm/min to measure the fracture load. The fracture surfaces of each test piece was observed with a high-resolution field emission scanning electron microscope. Through the above tests, the following results were obtained. 1. On the blasted surface, zirconia grains were locally removed but on the Zirface treated surface, a porous microstructure was created on the zirconia surface. 2. Arithmetical mean deviation from the mean line ra was the highest in the blasted group and the lowest in the polished group, and as a result of Tukey analysis, there were statistically significant differences between all test groups (P<0.05). 3. The maximum tensile bond strength was 18.8±5.4 MPa in the Zirface 30% group, and as a result of Tukey analysis, there was a statistically significant difference from the other test groups (P<0.05). 4. As a result of observing the fracture surface after the tensile test with a high-resolution field emission scanning electron microscope, in the Zirface 30% group, cohesive fracture and interfacial fracture in the resin was observed, but the other test groups showed the interfacial fracture pattern. In conclusion, within the limits of this study, treating the zirconia surface with Zirface 30% to form a porous microstructure can contribute to the improvement of the bond strength between zirconia and resin cement.

11.
Article in English | WPRIM | ID: wpr-893688

ABSTRACT

Shock thyroid is a rare manifestation of the CT hypotension complex and can be diagnosed when thyroid and perithyroidal edemas are observed on CT during the onset of shock. Shock thyroid can be a useful CT sign for decompensated shock. This condition is reversible and recovers rapidly with adequate treatment. We present the case of an 84-year-old female with septic shock, exhibiting CT features consistent with a shock thyroid. We also reviewed the clinical and radiological findings reported in the literature. The present case emphasizes that shock thyroid can be an early indicator of impending hemodynamic instability and has important prognostic and therapeutic implications.

12.
Article in Korean | WPRIM | ID: wpr-893231

ABSTRACT

Background@#Pompe disease is a rare autosomal recessive disorder caused by the deficiency of a lysosomal enzyme, acid alpha-glucosidase (GAA). Early diagnosis and initiation of treatment with enzyme replacement therapy have remarkable effects on the prognosis of Pompe disease. We performed the expanded screening for late onset Pompe disease (LOPD) at eight centers in Korea. @*Methods@#From September 1, 2015, GAA activity were measured from both dried blood spot (DBS) and mixed leukocyte for 188 available patients. For 12 patients with low GAA activity, we performed Sanger sequencing of GAA gene. @*Results@#Among 188 patients, 115 were males. The mean of age of symptom onset and diagnosis were 34.3 years and 41.6 years. Among 12 patients with decreased GAA activity, two patients were confirmed to have LOPD with genetic test (c.1316T>A [p.M439K] + c.2015G>A [p.R672Q], c.1857C>G [p.S619R] + c.546G>C [leaky splicing]). Other two patients had homozygous G576S and E689K mutation, known as pseudodeficiency allele. @*Conclusions@#This study is expanded study of LOPD screening for targeted Korean population. We found two patients with LOPD, and the detection rate of LOPD is 1.06%. With application of modified GAA cutoff value (0.4), which was previously reported, there were no false positive results of GAA activity test using DBS. Therefore, it could be an appropriate screening test for LOPD in especially East-Asian population, in which pseudodeficiency allele is frequent.

13.
Article in English | WPRIM | ID: wpr-892437

ABSTRACT

Objective@#: The widely accepted treatment option of a traumatic carotid cavernous fistula (TCCF) has been detachable balloon or coils based fistula occlusion. Recently, covered stent implantation has been proving an excellent results. The purpose of this study is to investigate our experiences with first line choice of covered stent implantation for TCCF at level 1 regional trauma center. @*Methods@#: From November 2004 to February 2020, 19 covered stents were used for treatment of 19 TCCF patients. Among them, 15 cases were first line treatment using covered stents. Clinical and angiographic data were retrospectively reviewed. @*Results@#: Procedures were technically successful in all 15 cases (100%). Immediate angiographic results after procedure were total occlusion in 12 patients (80%). All patients except two expired patients had image follow-up (mean 15 months). Recurred symptomatic three patients underwent additional treatments and achieved complete occlusion. Mean clinical follow-up duration was 32 months and results were modified Rankin Scale 1–2 in five, 3–4 in five, and 5 in three patients. @*Conclusion@#: The covered stent could be considered as fist line treatment option for treating TCCF patients especially in unstable vital sign. Larger samples and expanded follow-up are required to further develop their specifications and indications.

14.
Article in English | WPRIM | ID: wpr-891907

ABSTRACT

Purpose@#Currently, the most recommended method for burn first aid is the cool running water for 20 minutes (CRW20). If CRW20 is not practicable, cooling dressing products with tea tree oil are used as substitutes. In this study, we analyze the effect of various burn first aids, including CRW20, cooling products, on the treatment period. @*Methods@#This study was conducted on patients who suffered burns and visited Hangangsoo Hospital from March 2019 to March 2020. The study conducted in a retrospective method. The duration of treatment was analyzed by dividing the experimental group. @*Results@#The treatment period was shortened when first aid was given (P<0.001). Cold water, ice, and ice packs resulted in reduced treatment periods (P<0.001, P=0.004). The treatment period was reduced when cooling dressing products were used in all groups (P=0.041). The implementation of first aid has reduced the duration of burn treatment. This means that cooling helps burn treatment. CRW20 did not show statistically meaningful results. This is the result of a failure to fully control the temperature and time of tap water. In addition, the change in temperature of tap water according to season, the use of water is higher than that of animal testing, and the general lack of information on proper burn first aid may have affected. @*Conclusion@#The treatment period was statistically significantly reduced in the group that performed first aid. Among the various first aid methods, cold water and ice reduced the treatment period.

15.
Article in Korean | WPRIM | ID: wpr-919886

ABSTRACT

The aim of this study was to evaluate the antibacterial effect on Enterococcus Faecalis and physical properties of chitosan added calcium hydroxide canal filling material.Low, medium, high molecular weights of chitosan powder were mixed with calcium hydroxide canal filling material. Also, for each molecular weight group, 1.0, 2.0, 5.0 wt% of chitosan powder were added. An overnight culture of E. faecalis was adjusted to 1 × 106 CFU/ml. For test of antibacterial effect, three different molecular weights of 2.0 wt% chitosan and three different concentrations of high molecular weight chitosan were mixed with calcium hydroxide canal filling material. The absorbance of plates was analyzed using spectrophotometer at 570 nm with a reference wavelength of 600 nm. Physical properties such as flow, film thickness and radiopacity were examined according to ISO 6876 : 2012.All molecular weight type of chitosan containing material showed inhibitory effect against E. faecalis growth compared to non-chitosan added calcium hydroxide canal filling material group (p In conclusion, for reinforcement of antibacterial effect against E. faecalis and for favorable physical properties, 2.0 wt% of chitosan adding is recommended. Considering its antibacterial effect of chitosan, further studies are required for clinical application of chitosan in endodontics and pediatric dentistry.

16.
Article in English | WPRIM | ID: wpr-919372

ABSTRACT

Brain diseases and damages come in many forms such as neurodegenerative diseases, tumors, and stroke. Millions of people currently suffer from neurological diseases worldwide. While Challenges of current diagnosis and treatment for neurological diseases are the drug delivery to the central nervous system. The Blood–Brain Barrier (BBB) limits the drug from reaching the targeted site thus showing poor effects. Nanoparticles that have advantage of the assembly at the nanoscale of available biomaterials can provide a delivery platform with potential to raising brain levels of either imaging therapeutic drugs or imaging. Therefore, successful modeling of the BBB is another crucial factor for the development of nanodrugs. In this review, we analyze the in vitro and in vivo findings achieved in various models, and outlook future development of nanodrugs for the successful treatment of brain diseases and damages.

17.
Kosin Medical Journal ; : 148-152, 2021.
Article in English | WPRIM | ID: wpr-918385

ABSTRACT

Spontaneous resolution or thrombosis of giant or ruptured intracranial aneurysms is occasionally reported. However, spontaneous resolution of unruptured aneurysms without any intervention is extremely rare. Recently, we encountered a case of spontaneous resolution of a small unruptured aneurysm of the anterior communicating artery. We describe this rare case and discuss the mechanism of resolution with a review of the related literature.

18.
Yonsei Medical Journal ; : 95-98, 2021.
Article in English | WPRIM | ID: wpr-875597

ABSTRACT

Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant muscular disorder characterized by weakness of facial, shoulder, abdominal, hip girdle, humeral, and anterior distal leg muscles, with descending progression from the face to the legs in an asymmetric pattern. In about 5% of patients with FSHD, no D4Z4 repeat contraction on chromosome 4q35 is observed;this disease entity is called FSHD2. FSHD2 is characterized by DNA hypomethylation on the 4q-subtelomeric macrosatellite repeat array D4Z4. In Korea, there have been no previous reports of FSHD2. We report the first two cases of FSHD2 in Korea, carrying c.3801delG and c.1580C>T mutations in the SMCHD1 gene, respectively. For rapid and accurate diagnosis of FSHD2, genetic analysis of the D4Z4 haplotype and methylation with next-generation sequencing are required.

19.
Article in English | WPRIM | ID: wpr-889232

ABSTRACT

Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

20.
Article in English | WPRIM | ID: wpr-917974

ABSTRACT

Traumatic retropharyngeal hematoma is a potentially life-threatening complication of cervical spine injury due to possible airway obstruction. Treatment by securing airway and subsequent conservative care is often adequate. However, a rapidly expanding large hematoma requires surgical evacuation. We present a case of 55-year-old man with a retropharyngeal hematoma secondary to cervical vascular injury without associated cervical fracture. The patient was successfully treated with endovascular arterial embolization and subsequent percutaneous drainage under fluoroscopic guidance without any sequelae.

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